title: Safety and feasibility of novel technology fusing echocardiography and fluoroscopy images during MitraClip interventions.
abstract: OBJECTIVE
  The EchoNavigator (EN) software (Philips Healthcare, Best, The Netherlands) enables real-time fusion of echocardiography and fluoroscopy by co-registration of the echocardiography probe on the x-ray image. We aimed to evaluate the feasibility and safety of this novel software during MitraClip procedures.
  
  
  RESULTS
  Twenty-one patients were treated with the support of EchoNavigator software (EN+ patients). The primary (safety) endpoint was the total radiation dose. Secondary endpoints were fluoroscopy and total procedure time. The measurements were compared to those of 21 patients treated immediately before the installation of EchoNavigator (EN- patients). More MitraClips (45 vs. 36) were implanted in the EN+ group, mirroring more complex interventions in this group. In EN+ patients, radiation dose (Gy/cm2) was similar compared to EN- patients (146.5±123.6 vs.146.8±134.1, p=0.9). Total procedure time (minutes) was similar in the EN+ group compared to EN- patients (136.2±50.2 vs. 125.7±51.2, p=0.5). The main benefit of the EchoNavigator is the automated real-time fusion of echocardiography and fluoroscopy, leading to easier catheter manipulation.
  
  
  CONCLUSIONS
  The use of EchoNavigator software was feasible and safe in all study patients. Further studies are necessary to confirm the benefits of using this software.
authors.affiliation: Division of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Simon H
authors.initials: SH
authors.lastname: Sündermann
authors.forename: Patric
authors.initials: P
authors.lastname: Biaggi
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
authors.forename: Michael
authors.initials: M
authors.lastname: Gessat
authors.forename: Christian
authors.initials: C
authors.lastname: Felix
authors.forename: Dominique
authors.initials: D
authors.lastname: Bettex
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D004452:Echocardiography / Q000009:adverse effects / Q000379:methods*; D023381:Endpoint Determination; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D059032:Learning Curve; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008944:Mitral Valve Insufficiency / Q000628:therapy*; D011829:Radiation Dosage; D012984:Software; D016896:Treatment Outcome